Tobacco

Tobacco Márcio Padilha College of Southern Idaho ADDS 201 – Goffin Fall / 2009

Before the Common Era Circa 6000 BCE: Circa 1 BCE:

Circa 1 CE:

• Experts believe the tobacco plant, as we know it today, begins growing in the Americas. • (Whiteman, Day, & Nash, 2007)

• Historians believe American inhabitants begin finding ways to use tobacco, including smoking, chewing and hallucinogenic enemas. • (Borio, 2001)

• Tobacco was "nearly everywhere" in the Americas.

• (Borio, 1997)

Early Middle Ages Between 470-630 CE: • The Mayas began to disperse, spreading their custom to the neighboring peoples. • Believing their gods reveal themselves in the rising smoke, tobacco smoking becomes an entheogen. • A complex system of religious and political rites is created around tobacco. • (Hoffman, Radin, & Schoolcraft, 2007)

Early Modern Age

Columbus lands on the Bahamas and receives “certain dried leaves" from the natives, which are thrown away.

Europeans observe that such leaves are in high value among the natives.

Natives wrap leaves “in the manner of a musket formed of paper” and, after lighting one end, "drink" the smoke through the other. • (Borio, 1993)

Early Modern Age Rodrigo de Jerez is thought to be the first confirmed European smoker. He took the habit back to Spain. However, smoke coming from his mouth and nose frightens his neighbors.

Imprisoned by the Holy Inquisitors for 7 years. By the time he was released, smoking was a Spanish craze. • (Weaver, 2004)

Late Modern Age Post XVI Century: • “All along the sea routes ... wherever they had trading posts, the Portuguese began the limited planting of tobacco. Before the end of the sixteenth century they had developed these small farms to a point where they could be assured of enough tobacco to meet their personal needs, for gifts, and for barter. By the beginning of the seventeenth century these farms had, in many places, become plantations, often under native control.” • (Brecher, 2007)

Late Modern Age

(Wikipedia, 2009)

Tobacco in Early America

(Wikipedia, 2006)

Nicotiana

Nicotiana Rustica

Nicotiana Obtusifolia

Nicotiana Langsdorffii

(Wikipedia, 2006)

(Wikipedia, 2006)

(Wikipedia, 2007)

Nicotiana

Nicotiana Alata

Nicotiana Glauca

Nicotiana Sylvestris

(Wikipedia, 2009)

(Wikipedia, 2008)

(Wikipedia, 2007)

Pharmacology Inhaled nicotine is distributed quickly in the body through the bloodstream Can cross the blood-brain barrier On average it takes about seven seconds for the substance to reach the brain when inhaled Both a stimulant and a relaxant Activates reward pathways with intense addictive qualities Many studies it has been shown to be more addictive than cocaine and heroin.

(Xiu X, 2009)

Types of Tobacco Aromatic fire-cured

• Cured by gentle open fire smoke

Turkish Tobacco

• Sun-cured, aromatic, small-leafed variety

Brightleaf Tobacco

• Most commonly known brad leaf tobacco

Perique

• Pressure-fermented. Too strong to smoke

Burley Tobacco

• Air-cured tobacco

Shade Tobacco

• Cultivated in CT/MA. Puritan’s “Evil Weed”

Cavendish

• Curing process and cutting method

White Burley

Criollo Tobacco

• One of the original Caribbean tobaccos

Wild Tobacco

Dokham

• Iranian, mixed with leaves, bark and herb

Y1

• OH-planted, aircured, milder • Native to the SW USA, Mex, parts of S Ame

• Cross-bred, unusually high nicotine content. (World Health Organization, 2002)

Modes of Consumption Passive Smoking • Involuntary consumption of smoked tobacco • Second-hand smoke: burning end is present • Third-hand smoke: remaining smoke after the burning extinguished

Chewing/Smokeless Tobacco • Consumed by placing a portion of the tobacco between the cheek and gum or teeth and chewing

Cigars • Tightly rolled, dried and fermented tobacco, not inhaled due to high alkalinity • The United States is the top consuming country

(World Health Organization, 2002)

Modes of Consumption Electronic Cigarettes • No tobacco is consumed, battery-powered device, provides doses of vaporized nicotine

Hookah • Single or multi-stemmed, often glass-based, Operates by water filtration and indirect heat • Originally from India, Popular in the Middle East

Kretek • Complex blend of tobacco, cloves and a flavoring “sauce” • Introduced in the 1880’s in Java to deliver medicinal eugenol of cloves to the lungs.

(World Health Organization, 2002)

Modes of Consumption Pipe • Small chamber (the bowl), thin stem (shank), mouthpiece (the bit). • Tobaccos for pipe-smoking are carefully treated and blended to achieve flavor nuances not available in other tobacco products.

Midwakh • Small pipe of Arabian origin • Primarily found in the United Arab Emirates

Vaporizer • No burning of the herb, materials are heated in a partial vacuum, plant active compounds boil off into a vapor • Tobacco vaporizes between 284 °F – 392 °F (140°C/200°C)

(World Health Organization, 2002)

Modes of Consumption Bidi • Thin, often flavored, made of tobacco, wrapped in a tendu leaf • Low cost, Popular in Bangladesh, Pakistan, Sri Lanka, Cambodia and India

Hand-rolled Cigarette • Hand-rolled cigarettes, very popular in European countries • Prepared from loose tobacco, cigarette papers and filters all bought separately, usually much cheaper to make

Industrialized Cigarette • Consumed through smoking/inhaling, manufactured out of finelycut cured tobacco leaves, reconstituted tobacco and additives • Most common method of consumption

(World Health Organization, 2002)

What’s in a cigarette?

(Cornell University, 2008)

What’s in a cigarette?

Making of a Cigarette

http://www.youtube.com/watch_popup?v=vNCIVetOmEY (History Channel, 2007)

Acute Effects of Tobacco Usage

(Center for Desease Control, 2009)

Tobacco Tolerance Nicotine Strength

Quantity

Speed

Frequency

(Center for Desease Control, 2009)

Physical Effects of Tobacco Usage

(Wikipedia, 2009)

Chronic Effects of Tobacco Usage Cerebral Atrophy

Cognitive dysfunction

Reduced cognitive abilities in adolescent smokers

Increased risk of Alzheimer's disease Reduced memory in adolescent smokers

(WHO, 2009)

Withdrawal Symptoms

Jitteriness

Dry Mouth

Irritability

Tachycardia

Insomnia

Depression

(WHO, 2009)

Overdose Symptoms Nausea

Palpitations

Vomiting

Stomach Pain

Diarrhea

Stomach Cramps

Headaches

Seizures

Difficulty Breathing

Weakness

Sweating

Drooling (Center for Desease Control, 2009)

Nicotine Poisoning Five cigarettes for an adult. One half cigar for an adult.

One cigarette for a toddler. (Center for Desease Control, 2009)

Children and Nicotine Poisoning Many children get nicotine poisoning after eating cigarettes or cigarette butts. Children have also become poisoned by topical medicinal creams containing nicotine. (Center for Desease Control, 2009)

Synergism Social: Demographics:

Health: Economic: Political:

• Masculinity • Power • Social Status • Promiscuity • Developing countries and transitional economies are more likely to consume tobacco than developed countries. • Leads to a vast array of diseases primarily affecting the heart and lungs as well as different types of cancer. • Much of the disease burden and premature mortality attributable to tobacco use disproportionately affect the poor. • Tobacco lobby gives money to politicians to vote in favor of deregulating tobacco.

(WHO, 2003)

United States, 1940’s

Synergism

http://www.youtube.com/watch_popup?v=gCMzjJjuxQI (Camel, 1942)

United States, 1960’s

Synergism

http://www.youtube.com/watch_popup?v=Bvt8skgm2l8 (Winston, 1962)

Worldwide, 1990’s

Synergism

http://www.youtube.com/watch_popup?v=jo6MXUPI22g (Hollywood, 1991)

Unique Pocket of Resistance

(Wikipedia, 2006)

Have you seen this picture before?

(Wikipedia, 2006)

BHUTAN

The only country where tobacco sales is illegal

(Wikipedia, 2009)

Tobacco Treatment Issues Age of Onset and Length of Addiction

Tobacco Legality

Tobacco Availability

Tobacco Low Cost

Nonhallucinogenic Properties

Physical Dependence

(Center for Desease Control, 2009)

Treatment

Rally support

Self Motivation

Therapeutic Assistance

Courage and willingness to bounce back from relapse (Center for Desease Control, 2009)

Societal Effects

MORTALITY

Average Shortening of Lifespan in Years 14.5

13.2

Males

Females (WHO, 2008)

RISK OF DYING FROM LUNG CANCER BEFORE AGE 85

Societal Effects Males

Females

22.1

11.9

1.1 Smoker

0.8

Non-Smoker (WHO, 2008)

LUNG CANCER

Societal Effects

http://www.youtube.com/watch_popup?v=muNne9qBmMk (Australia N. A.-T., 1997)

Societal Costs

Property Damage Judicial System

Health Care

Percentage of females smoking any tobacco product.

Societal Usage of Tobacco

(WHO, 2008)

Percentage of males smoking any tobacco product.

Societal Usage of Tobacco

(WHO, 2008)

Prevention: World Health Organization

Adversities to Prevention Trade Liberalization International Contraband and Counterfeit

Transnational Advertising, Promotion and Sponsorship

Direct Foreign Investment

Global Marketing

(WHO, 2003)

World Health Organization

Framework Convention on Tobacco Control Evidencebased.

Asserts the Paradigm Reaffirms importance shift in the right of of demand developing all people to reduction a regulatory the highest strategies as strategy to standard of well as address supply addictive health. issues. substances. (WHO, 2003)

World Health Organization

Framework Convention on Tobacco Control Adopted by the World Health Assembly on May 21, 2003.

Entered into force on 02/27/2005.

One of the most widely embraced treaties.

166 Signatories.

05/10/2004: USA became a signatory.

As of 11/18/2009, not ratified by the USA.

(WHO, 2003)

11/18/2009

World Health Organization Article 5.3:

Articles 6 & 7:

• Call for a limitation in the interactions between lawmakers and the tobacco industry.

• Tax and other measures to reduce tobacco demand.

Article 9 & 11:

Article 10:

Article 8:

• Large health warning (at least 30% of the packet cover, 50% or more recommended); deceptive labels ("mild", "light", etc.) are prohibited.

• The contents and emissions of tobacco products are to be regulated and ingredients are to be disclosed.

• Obligation to protect all people from exposure to tobacco smoke in indoor workplaces, public transport and indoor public places.

Framework Convention on Tobacco Control

(WHO, 2003)

World Health Organization Article 12:

Article 13:

Article 14:

• Public awareness for the consequences of smoking.

• Comprehensive ban, unless the national constitution forbids it.

• Addiction and cessation programs.

Articles 20, 21, & 22:

Article 16:

Article 15:

• Restricted sales to minors.

• Action is required to eliminate illicit trade of tobacco products.

• Tobacco-related research and information sharing among the parties.

(WHO, 2003)

Prevention Public Health Cigarette Smoking Act of 1970

"Warning: The Surgeon General Has Determined that Cigarette Smoking Is Dangerous to Your Health.”

Banned cigarette advertisements on American radio and television. (Center for Desease Control, 2000)

Prevention Comprehensive Smoking Education Act of 1984 (PL 98–474) SURGEON GENERAL’S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.

SURGEON GENERAL’S WARNING: Quitting Smoking Now Greatly Reduces Serious Risks to Your Health.

SURGEON GENERAL’S WARNING: Smoking by Pregnant Women May Result in Fetal Injury, Premature Birth, and Low Birth Weight.

SURGEON GENERAL’S WARNING: Cigarette Smoke Contains Carbon Monoxide.

(Center for Desease Control, 2000)

Prevention

Framework Convention on Tobacco Control

• Large Health Warning

• No Deceptive Labels

(WHO, 2003)

Prevention

(Instituto Nacional de Câncer, 2009)

Prevention

(Instituto Nacional de Câncer, 2009)

Prevention Victim of this Product:

Gangrene:

This product intoxicates mother and child causing premature birth and death

Using this product clogs up arteries making blood circulation difficult.

(Instituto Nacional de Câncer, 2009)

Prevention Death:

Heart Attack:

Using this product causes death due to lung cancer and emphysema.

Using this product causes death due to cardiac diseases.

(Instituto Nacional de Câncer, 2009)

Prevention Toxic Smoke:

Horror:

Breathing this product’s smoke causes pneumonia and bronchitis.

This product causes premature skin aging.

(Instituto Nacional de Câncer, 2009)

Prevention Impotence:

Stroke:

Using this product diminishes, causes difficulties or impedes erections.

Using this product will increase the risk of stroke.

(Instituto Nacional de Câncer, 2009)

Prevention Toxic Product:

Suffering:

This product contains toxic substances which cause sickness and death.

Nicotine dependence leads to sadness, pain and death.

(Instituto Nacional de Câncer, 2009)

Prevention Mauritius: Smoking causes a slow and painful death.

Canada

(WHO, 2009)

Prevention Chile:

Panama:

In Chile, tobacco kills 16,000 persons every year. The next can be you.

Smoking causes cardiovascular diseases.

(WHO, 2009)

Prevention Peru: Smoking causes miscarriages.

Singapore

(WHO, 2009)

Prevention Iran: Smoking can cause permanent damage to the eyes, nerve tissues and it can make you blind after all.

Belgium

(WHO, 2009)

Prevention Hong Kong

Thailand: Smoking and Larynx Cancer

(WHO, 2009)

Prevention New Zealand

Australia

(WHO, 2009)

CHILE

Prevention

http://www.youtube.com/watch_popup?v=-F8X_OZgbrw

(Chile, 2009)

BRAZIL

Prevention

http://www.youtube.com/watch_popup?v=yJJhInXnQjY (Brasil, 2004)

INDIA

Prevention

http://www.youtube.com/watch_popup?v=Sm5UyrEqGhQ

(India, 2009)

AUSTRALIA

Prevention

http://www.youtube.com/watch_popup?v=Sm5UyrEqGhQ

(Australia, 2006)

Praxis of Prevention in the USA

Emphasis

Legislative

Punitive

Smoking Ban in the United States

(Wikipedia, 2009) c

Smoking Ban in the United States

(Wikipedia, 2009)

Prevention

• Interaction Framework limitation between Convention lawmakers and on Tobacco the tobacco Control industry (WHO, 2003)

The 1992 Lobby Industry in US$ Thousands

$2,004,866 $1,853,741 $1,675,219 $1,484,731 $1,444,412

$1,354,547 $1,338,659

$957,261

$865,230

$803,197 $514,447

(Ferraro, 1992)

Factoid

At US$2,004,866,000; the 1992 Tobacco Industry Lobby Budget in the United States is greater than the 2008 Gross Internal Product of 14 Sovereign Nations in world.

Djibouti

US$ 1,880,000,000

(Wikipedia, 2009)

Cape Verde

US$ 1,749,000,000

(Wikipedia, 2009)

Liberia

US$ 1,471,000,000

(Wikipedia, 2009)

Maldives

US$ 1,261,000,000

(Wikipedia, 2009)

Samoa

US$ 1,088,000,000

(Wikipedia, 2009)

Guinea-Bissau

US$ 848,000,000

(Wikipedia, 2009)

Gambia

US$ 810,000,000

(Wikipedia, 2009)

Solomon Islands

US$ 642,000,000

(Wikipedia, 2009)

Vanuatu

US$ 573,000,000

(Wikipedia, 2009)

Comoros

US$ 532,000,000

(Wikipedia, 2009)

East Timor

US$ 499,000,000

(Wikipedia, 2009)

São Tomé and Príncipe

US$ 175,000,000

(Wikipedia, 2009)

Kiribati

US$ 137,000,000

(Wikipedia, 2009)

Tuvalu

US$ 14,000,000

(Wikipedia, 2009)

Prevention

Framework Convention on Tobacco Control

• Public awareness for the consequences of smoking. (WHO, 2003)

Prevention CDC 2009

WHO 2009

Prevention

So… …which type of prevention approach do you feel to be the most efficient?

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